[Assessment of cognitive functions in internal medicine]

[Assessment and impairment of cognitive functions]

Cognitive functions enable us to receive, select, store, transform, process and retrieve the information we receive from the outside world. These functions are controlled by different brain structures that interact with each other, enabling us to interact with and understand the world around us. In the course of aging or the onset of neurocognitive diseases, these functions may be impaired to a greater or lesser extent, giving rise to a considerable variety of neurocognitive impairment profiles. When a patient appears to be suffering from neurocognitive disorders, a thorough neuropsychological evaluation can help to characterize this impairment precisely, before guiding therapeutic management. It also contributes significantly to the etiological diagnosis of the disorder.

[Importance of cognitive disorders in internal medicine: Pathophysiology, diagnosis, management. The example of systemic lupus erythematosus]

Systemic diseases, which are in France mainly monitored in internal medicine, affect multiple organs or tissues. While cutaneous or articular manifestations are the most common, neurological involvement is often associated with severity. Diagnosis of peripheral (e.g, neuropathies) or central (e.g, myelitis) nervous disorders is quite easy through clinical examination and dedicated complementary tests. However, neuropsychological manifestations that affect cognition, including memory, attention, executive functions or reasoning, are difficult to diagnose, sometimes trivialized by practitioners. Their causes are often numerous and interrelated. Nevertheless, these cognitive manifestations are closely related to patients' quality of life, affecting their social life, family dynamics and professional integration but also the treatment adherence. The purpose of this review, focused on the example of systemic lupus erythematosus, is to raise awareness of cognitive dysfunction in systemic diseases including their management from diagnosis to treatments. The final aim is to go further into setting up research groups and care programs for patients with cognitive impairment followed in internal medicine.